Federal Reports

When Congress established average sales price (ASP) as the basis for Medicare Part B drug reimbursement, it also provided a mechanism for monitoring market prices and limiting potentially excessive payment amounts. The Social Security Act mandates that OIG compare ASPs with average manufacturer prices (AMPs). If OIG finds that the ASP for a drug exceeds the AMP by a certain percentage (currently 5 percent), the Act directs the Secretary of Health and Human Services to substitute the ASP based payment amount with a lower calculated rate. Through regulation, CMS outlined that it would make this substitution only if the ASP for a drug exceeded the AMP by 5 percent in the 2 previous quarters or 3 of the previous 4 quarters.

OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units' performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. These reviews assess the Units' adherence to the 12 MFCU performance standards and compliance with applicable Federal statutes and regulations.

This is our final audit report on the effectiveness of NOAA real property management. Specifically, we assessed whether NOAA has an adequate understanding of its repair needs and is monitoring real property utilization.

We performed this audit to determine whether NARA's FOIA process was efficient, effective, and complied with current laws and regulations. We also assessed internal controls in place to ensure NARA responded to FOIA requests timely and accurately.

Of the $10.0 million in Low-Income Home Energy Assistance Program (LIHEAP) grant funds that the Administration for Children and Families awarded to the Turtle Mountain Band of Chippewa Indians (TMT) for Federal fiscal years 2010 through 2013, TMT did not administer LIHEAP grant funds totaling $587,248 in compliance with Federal laws, regulations, and guidance. In addition, TMT could not determine whether an additional $96,932, which home energy suppliers had returned to the tribe, was subject to repayment because it did not track from which grant period those additional funds originated. TMT is a federally recognized Native American tribe located in North Dakota. The errors we identified occurred because TMT did not have policies and procedures or internal controls in place to prevent them.

In this classified report, we identified vulnerabilities with TSA's screener performance, screening equipment, and associated procedures. Details related to our testing results presented in the report are classified or designated Sensitive Security Information. We are making eight recommendations that when implemented, should improve TSA's screening checkpoint operational effectiveness.

The VA Office of Inspector General (OIG) conducted its fourth determination of Veterans Health Administration (VHA) occupations with the largest staffing shortages as required by Section 301 of the Veterans Access, Choice, and Accountability Act of 2014 (VACAA). We determined that the largest critical need occupations were Medical Officer, Nurse, Psychologist, Physician Assistant, and Medical Technologist.Our analysis of the staffing gains and losses for this year’s report shows that for critical need occupations, a significant percentage of the total gains continue to be offset by staff losses. At the time of the writing of this report, VHA still does not have operational staffing models that comprehensively cover critical need occupations. In the absence of facility-specific staffing targets or an operational staffing model, determining whether facilities are making meaningful progress in filling critical staffing shortages is challenging.VHA chartered a work group to consider ways to reduce regrettable losses. The work group’s report focused on the need for additional studies to determine causative and other factors related to regrettable losses. The work group reported issuing a follow-up report in September 2017. In an effort to better understand staffing processes and identify staffing barriers, we conducted a survey of 141 VHA facilities in May 2017. We received a request from Senator Thom Tillis to evaluate staffing requirements and demand for select non-physician professionals. We included questions in the survey related to those professionals (optometrists, pharmacists, and medical technicians). We made four recommendations to the Acting Under Secretary for Health.